MPI CRV 2017 Summer/Fall CMP Study Group: Jul 25 - Oct 24, 2017

Please register for our 2017 Summer/Fall CMP Study Group by completing the form below. If you have any questions, contact Allyson J. Deckman at (860) 541-6438 or mpicrv@gmail.com.

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Personal Information

First Name: *
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Pursuant to the American with Disabilites Act, do you require specific aid or services?
Special Needs:
Do you know of anyone that would be interested in learning more about MPI CRV?

Guest Information

Photo Release Statement

I give the MPI Connecticut River Valley Chapter, the absolute right and permission to use my photograph(s) in its promotional materials and publicity efforts. I understand that the photograph(s) may be used in a publication, print ad, direct-mail piece, electronic media (e.g. video, CD-ROM, Internet, World Wide Web), or other form of promotion for the Chapter. I release MPI CRV, the photographer, their offices, employees, agents, and designees from liability for any violation of any personal or proprietary right I may have in connection with such use.
I have read and agree with the Photo Release Statement. *  

Donations

Would you like to make a donation to the MPI Foundation? If so, please enter the amount here: Amount: $

Payment Information

Please choose the number of registrations for each pricing category:
MPI CRV Member Quantity: Cost: $75.00
Non-Member Quantity: Cost: $150.00
Payment Method: *  
  • For more information:
    MPI CRV, Attn: Allyson J. Deckman
    701 Hebron Ave - Third Floor, Glastonbury, CT 06033
  • Confirmation of your registration will be sent via email.

Payment and Cancellation Policy

  • All cancellations must occur by 5:00 pm on 7/18 for full refund; no refunds after 7/18
  • Anyone who does not show for the event will be charged.
  • I have read and agree with the above Payment and Cancellation Policy. *  

    Credit Card Payment Information

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    Confirmation Email

    Send Confirmation Email To: *


    MPI CONNECTICUT RIVER VALLEY CHAPTER

    701 Hebron Avenue - 3rd Floor
    Glastonbury, CT 06033
    Phone: 860.541.6438

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